Provider Demographics
NPI:1386659977
Name:MOVSHOVICH, ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:MOVSHOVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:596 ANDERSON AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-1856
Mailing Address - Country:US
Mailing Address - Phone:201-943-0022
Mailing Address - Fax:201-313-7146
Practice Address - Street 1:596 ANDERSON AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-1856
Practice Address - Country:US
Practice Address - Phone:201-943-0022
Practice Address - Fax:201-313-7146
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06814200207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ032984Q95OtherMEDICARE RENDERING NUMBER
NJ7964200Medicaid
NJ7964200Medicaid
NYG68271Medicare UPIN
NY94T741Medicare ID - Type Unspecified
NJ7964200Medicaid